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Krisman

THIRD EDITION 2008 - 2009

MANAN SHROFF

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Krisman

This reference guide is not intended as a substitute for the advice of a physician. Students or readers must consult their physician about any existing problem. Do not use any information of this reference guide for any kind of self treatment. Do not administer any dose of mentioned drugs in this reference guide without consulting your physician. This is only a review guide for preparation of pharmaceutical calculations.

The author of this reference guide is not responsible for any kind of misinterpreted, incorrect or misleading information or any typographical errors in this guide. Any doubtful or questionable answers should be checked in other available reference sources.

All rights reserved. No part of this guide may be reproduced or transmitted in any form or by any means, electronically photocopying, recording or otherwise, without prior written permission of the publisher. RXEXAM is a registered trademark of Pharmacy Exam of Krishna Publication inc. Any unauthorized use of this trade mark will be considered a violation of law.

NAPLEX and FPGEE exams are federally registered trademark owned by National Association Board of Pharmacy (NABP). PTCB is registered trade mark owned by Pharmacy Technician Certification Board and this review guide is in no way authorized or sponsored by NABP or PTCB.

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Krisman

PREFACE

Reference guide for Pharmaceutical calculations is a resourceful practice guide for preparation of the NAPLEX, FPGEE , California Pharmacy Board Exam and PTCB exams. It contains more than 600 calculation problems to prepare students to tackle an actual exam. NAPLEX, FPGEE, California Pharmacy Board Exam and PTCB exams are currently putting more emphasis on calculation problems. 25 % to 30% of NAPLEX, FPGEE, California Pharmacy Board Exam and PTCB exams consist of calculations. Calculations related to I.V., I.V. infusion, TPN and dosages are very important in retail and institutional pharmacy settings. This guide will provide complete practice on related calculation problems and help to achieve an exceptional score on the examinations.

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Krisman

TABLE OF CONTENTS

SECTION - I

1. 2. CALCULATIONS ANSWERS 7 36

SECTION - II

1. 2. PRACTICE CALCULATIONS ANSWERS 72 105

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Reference Guide For Pharmaceutical Calculations Third Edition COMMONLY USED UNITS FOR PHARMACEUTICAL CALCULATIONS * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 1 kilogram 1 gram 1 milligram 1 microgram 1 microgram 1 nanogram 1 grain 1 liter 1 ounce (oz) 16 ounce (oz) 1 pint 1 quart 1 gallon 1 kg 1 lb 1 teaspoonful 1 tablespoonful 1 teacupful Density Proof gallon % strength Proof gal PV PV Equivalent wt mEq mOsmol/L pH Young (child) Clarks Childs dose Frieds rule FP of blood = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = =

Krisman

1000 grams 1000 milligrams 1000 micrograms 0.001 milligrams 10-6 grams 10-9 grams 65 milligrams 1000 cc 30 cc 480 cc = 1 pint 480 cc 960 cc = 2 pints 3840 cc = 8 pints = 4 quarts 2.2 lbs 454 grams 5 cc 15 cc 120 cc weight/volume (gal x % v/v strength) / 50% v/v proof spirit / 2 (gal x proof spirit) / 100 nRT W/M x R x T molecular weight / number of valence equivalent weight in mg / 1000 (weight of substance [g/L] x no of species x 1000) / mol wt pKa + log (salt/acid) (age in years / age + 12) x adult dose (weight in lbs / 150) x adult dose (body surface area of child / 173 mm2 ) x adult dose (age in months / 150) x adult dose -0.52oC = = = = = = = = = 3.4 calories / kcal 4 calories / kcal 9 calories / kcal 4 calories / kcal 8.3 calories / kcal 4.3 calories / kcal 5.6 calories / kcal 1.1 calories / kcal 2.0 calories / kcal

Each gm of hydrous dextrose provides Each gm of anhydrous dextrose provides Each gm of fat provides Each gm of protein/aminoacid provides Each gm of medium chain triglyceride (mct) Each gm of glycerol provides Each cc of alcohol provides 1 cc of 10% fat emulsion provides 1 cc of 20% fat emulsion provides

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Reference Guide For Pharmaceutical Calculations Third Edition * * * pH pH B = = = pKa + log (salt/acid) or (ionized/unionized) (for weak acid) pKw - pKb + log (base/salt) (for weak base) 2.3 x C Ka x H3O+ (Ka + H3O+)2

Krisman

where, C = total buffer concentration, H3O+ = hydrogen ion concentration * Bmax = 0.576 x C (maximum buffer capacity)

where C = total buffer concentration * * * * * Acceleration gravity (g) Gas constant (R) 1 calorie Avogrados number K = 2.303 log Co t C t 1/2 = 0.693/K Vd = M/Cp = = = = 980 cm/sec2 0.082 lit atm / mole deg 4.184 x 107 erg 6.0221 x 1023 mole-

where Co = initial concentration of drug where C = concentration of drug at time t where t1/2 = half life of drug where K = rate constant where Vd = volume of distribution where M = amount of drug in body where Cp = plasma concentration of drug where Ri = rate of infusion where Css = steady state plasma concentration where Vd = volume of distribution where K = drug elimination constant where Ld = loading dose of drug where Css = steady state plasma concentration where Vd = volume of distribution It is defined as the presence of number of gram equivalent weight of solute in 1000 ml or (1L) solution. It is defined as the presence of number of moles of solute in 1000 ml or (1L) of solution. It is defined as the presence of number of moles of solute in 1000 gm of solvent.

Ri = Css x Vd x K

Ld = Css x Vd

Normality (N):

Molarity (M):

Molality (m):

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Reference Guide For Pharmaceutical Calculations Third Edition * Temperature conversion: CrCl = 9 (oC) = 5 (oF) - 160

Krisman

CrCl (female) =0.85 x male (CrCl) Total digitalis body load in mg x 0.8 0.5mg of digitalis bound

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Krisman

QUESTIONS

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Krisman

1.

6.

How many cc of 75% alcohol should be mixed with 10% of 1000 cc alcohol to prepare 30% of 500 cc alcohol solution ? a. b. c. d. 346.16 cc 234.43 cc 153.84 cc 121.12 cc

Find out the amount of Sulfur required to fill the above prescription? a. b. c. d. 1.2 gm 2.4 gm 3.0 gm 4.8 gm

7.

a. b. c. d.

How many grams of Heparin are required to prepare 1 quart of 0.45% solution? 2.16 gm 4.32 gm 0.45 gm 4.5 gm

2.

a. b. c. d.

How many grams of Dextrose are required to prepare 5% of 500 cc solution? 2.5 gm 25 gm 55 gm 5 gm

8.

3.

a. b. c. d.

How much Lidocaine is required to prepare 1 : 1000, 30 cc of solution of Lidocaine? 10 mg 0.03 mg 30 mg 300 mg

If a prescription reads Augmentin 875 mg po bid x 10 days, how many cc ofAugmentin 250 mg/5 cc are required to fill a ten-day supply? a. b. c. d. 350 cc 35 cc 17.5 cc 5 cc

9. 4.

a. b. c. d. How many milligrams are equal to 1/150 gr of Nitroglycerine? 150 mg 65 mg 55 mg 0.43 mg

If 250 mg of Cefazolin powder are diluted with water up to the 250 cc mark, what is the % of drug in the final solution ? a. b. c. d. 10% 0.1% 11% 0.01%

5.

a. b. c. d.

How much Atropine is required to dispense 1 quart of 1 in 100 solution? 9.6 mg 1.48 gm 2.3 mg 9600 mg

10.

If 1 teaspoonful of Thioridazine concentrated solution (30 mg/cc) is diluted up to the 480 cc mark with plain water, what is the strength of drug in mg/ml in the final solution ? a. b. 1mg/cc 0.52 mg/cc

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Reference Guide For Pharmaceutical Calculations Third Edition c. d. 0.31 mg/cc 0.75 mg/cc a. b. c. d. 4 3 1 2

Krisman

11.

If a prescription reads Diphenhydramine 50 mg po hs x 30 days , what would be the dispensed quantity of drug in ml (12.5 mg / 5 cc) for thirty-day supply? a. b. c. d. 20 cc 5 cc 300 cc 600 cc

16.

If 1000 tablets of Risperdal 1 mg cost $2250 and the mark-up on prescription is 20%, what would be the retail price for 30 tablets? a. b. c. d. $150 $17 $500 $81

12.

a. b. c. d.

Erythromycin 2% 60 cc topical solution contains: 2 gm erythromycin 2.4 gm erythromycin 0.6 gm erythromycin 1.2 gm erythromycin

17.

a. b. c. d.

How much Clobetasole is present in 60 gm of 0.5% ointment? 1.2 gm 3.0 gm 2.1 gm 0.3 gm

13.

If 60 mg of elementary iron are present in 325 mg of ferrous sulfate, what is the % of elementary iron? a. b. c. d. 20.00% 10.25% 18.46% 9.25%

18.

If the ratio of ionized to unionized species of drugs is 103 and PKa = 2.2, what is the pH of the solution? a. b. c. d. 2.2 0.8 5.2 3.0

14.

If 60 gm of 1% hydrocortisone are mixed with 80 gm of 2.5% hydrocortisone, what is the % of hydrocortisone in the final mixture? a. b. c. d. 2.2% w/w 1.85% w/w 0.25% w/w 1.75% w/w

19.

If a prescription reads Augmentin 875 mg by mouth twice a day, how many cc of Augmentin 400 mg/5 cc are required to dispense a 10 day supply? a. b. c. d. 10.93 cc 218.75 cc 75.00 cc 100.00 cc

15.

If a prescription reads 100 mcg cyanocobalamin i.m. every week, how many ampuls of 1000 mcg / cc are required to fill a month supply?

20.

Find out the weight in gm of 500 cc glycerine. [Specific gravity = 1.25 gm/ml]

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Reference Guide For Pharmaceutical Calculations Third Edition a. b. c. d. 625 gm 50 gm 400 gm 0.25 gm

Krisman

26.

How many 500 mg tablets of erythromycin are required to prepare 240 cc of 2% solution of erythromycin? a. b. c. d. 3 5 6 10 How many milligrams are equal to 1/150

21.

a. b. c. d.

Find out the volume of 5 lb of glycerine. [density = 1.25 gm/ml] 1816 cc 6.25 cc 637 cc 40 cc

27.

grains? a. b. c. d.

22.

a. b. c. d.

Calculate the weight of 500 cc of acid. [density of acid = 2.5 gm/ml] 1000 gm 1250 gm 500 gm 200 gm

28.

a. b. c. d.

How many 975 mg tablets of aspirin are required to prepare 100 tablets of 1 grain? 6 tablets 10 tablets 5 tablets 3 tablets

23.

a. b. c. d.

Find out the ratio of ionized to unionized species of drugs at pH = 7. [pKa = 5] 10 1 100 1000

29.

If 3 capsules of 150 mg of Clindamycin are added to 150 cc of 1% Cleocin topical solution, what is the % of Clindamycin in the final mixture ? a. b. c. d. 1.5% 1.3% 1.1% 0.9%

24.

a. b. c. d.

If the pH of the solution is 3, what is the concentration of H3O+ in gm ion /L? 0.01 gm-ion/L 1 x 103 gm-ion/L 0.05 gm-ion/L 10-3 gm-ion/L

30.

25.

What is the pH of a solution having a ratio of ionized to unionized species of drugs of 1 x 106 ?[PKa = 7] a. b. c. d. 2 5 3 1

The adult dose of a drug is 500 mg. What is the dose for a 2 year old child? [use young rule] a. b. c. d. 71.42 mg 101.53 mg 25.46 mg 31.18 mg

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Krisman

31.

a. b. c. d.

The adult dose of a drug is 750 mg, what is the dose for child weighing 20 lbs? 100 mg 250 mg 500 mg 425 mg

36.

If the prescription calls for 50 micrograms of a drug three times daily for 10 days, how many 1/100 grain tablets are required to fill the above order ? a. b. c. d. 5 tablets 3 tablets 1 tablet 6 tablets

32.

If a dropper is calibrated to deliver 325 mg of iron sulfate in 0.6 cc and an adult dose of drug is 325 mg, what is the dose of a drug in cc for a 15 month old infant? a. b. c. d. 1.2 cc 0.3 cc 0.06 cc 0.01 cc

37.

If a prescription reads Lanoxin 0.125 mg by mouth every day, how many cc of Lanoxin 50 mcg/cc are required to dispense a 30 day supply? a. b. c. d. 75 cc 50 cc 100 cc 240 cc

33.

If an adult dose of a drug is 100 mg, what would be the dose for a child having a body surface area of 20 mm2 ? a. b. c. d. 5.51 mg 12.32 mg 20.60 mg 11.56 mg How many milligrams are in 10 grains of

38.

If a prescription reads to dissolve 2 gm of guaifenesin in 100 cc of water, how many grains of guaifenesin are present in 1 teaspoonful of solution? a. b. c. d. 1.53 grains 2.61 grains 3.15 grains 4.20 grains

34.

aspirin? a. b. c. d.

81 mg 60 mg 325 mg 650 mg

39.

a. b. c. d.

If 100 mg of Lactin is equal to 4500 units, how many milligrams are required to obtain 1 unit? 2.22 mg 0.02 mg 3.25 mg 4.50 mg

35.

If a normal dose of a drug is 10 mg/kg/ day, how many 250 mg/100cc ready-infusion bags are required to fill the above order ? [Patients weight is 156 lbs.] a. b. c. d. 1 bag 2 bags 3 bags 5 bags

40.

If a prescription reads Ampicillin 50 mg by mouth twice a day for a 7 year old child, how many cc (125 mg/5 cc) are required to dispense a 7 day supply of the drug?

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Reference Guide For Pharmaceutical Calculations Third Edition a. b. c. d. 150 cc 240 cc 28 cc 56 cc c. d. 0.003 mg 300 mg

Krisman

46.

a. b. c. d.

How much Povidone-Iodine is required to prepare 1000 cc of 1 in 750 solution? 1.33 gm 3.12 gm 1.25 gm 0.95 gm

41.

What is the dose of a drug for a person having 110 m2 body surface area? The average adult dose of the drug is 750 mg. a. b. c. d. 1089 mg 625 mg 531 mg 477 mg

47.

42.

a. b. c. d.

How many grams of a drug are required to prepare 240 cc of 10% solution? 12 gm 36 gm 48 gm 24 gm

48.

a. b. c. d.

43.

How many grams of sodium chloride are required to make 750 cc of 0.9% normal saline solution? a. b. c. d. 1.35 gm 2.50 gm 6.75 gm 12.25 gm

49.

To dispense 5% of 250 cc solution of thioridazine, how many cc of 30 mg/cc are required? a. b. c. d. 225 cc 153 cc 511 cc 417 cc

44.

a. b. c. d.

How many grams of dextrose are present in 500 cc of D25W solution? 50 grams 125 grams 75 grams 25 grams

50.

If 20 cc of risperdal 1mg/cc are diluted with water up to 240 cc mark, what would be the strength of drug in mg /ml? a. b. c. d. 2.2 mg/cc 1 mg/cc 0.1 mg /cc 0.08 mg/cc

45.

a. b.

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13

250. How much dextrose is required to prepare 1 in 100, 50 cc dextrose solution? a. b. c. d. 0.5 gm 2 gm 1.5 gm 3.6 gm

KCl) should dissolve in 12oz of water. If 5cc of this resultant solution is diluted up to the 25cc mark with plain water, what would be the final concentration of KCl in mg/cc? (K = 39, Cl = 35.5) a. b. c. d.1 3.15 1.51 1.27 1.64

present in a 5% 1 pint sodium bicarbonate solution? [MW = 84 gm/mole] a. b. c. d. 121.58 312.54 285.71 243.20

daily, how many cc of Kaletra (80mg/20mg per ml) oral solution are required to fill a 7-day supply? a. b. c. d. 180cc 140cc 530cc 215cc

3.7mg/dl, what would be the creatinine clearance value in ml/min? (Patients age = 52 years; Weight = 185lbs.) a. b. c. d. 56.6 ml/min 70.1 ml/min 98.5 ml/min 27.78 ml/min

many 8 ounce bottles of Ensure are required to provide 0.1Kcal? a. b. c. d. 6 1 9 2

ml) is 0.01 mcg/kg four times weekly, approximately how many ampules are required to fill a week supply? (Patients weight = 110 lbs.) a. b. c. d. 9 7 1 5

present in each ml of a 0.015% eye drop? a. b. c. d. 1.25 0.15 5.45 2.21

(5mg/ml) is 0.25 mcg/kg/min, how long will it take to finish up 2.5mg/ml? (Patients weight = 110 lbs.) a. b. 4 hrs 5 hrs

0.0002% ophthalamic solution. How many milligrams of drug is present in each ml of solution?

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Reference Guide For Pharmaceutical Calculations Third Edition a. b. c. d. 0.526 2.5 0.125 0.002 c. d. 0.56 1.04

Krisman

80% compared to digoxin I.V. dosage formulations. If a prescription says 5ml (25mcg/ ml) per day, what would be an equivalent dose of the drug in milligrams for I.V. dosage form? a. b. c. d. 0.25 0.125 0.1 0.75

aqua nasal spray is 32mcg daily as one spray per nostril. If nasal spray provides 40 sprays (each with 16mcg) after initial priming, how many days will this nasal spray last? a. b. c. d. 10 30 60 5

provides the following information: Amount per serving %DV Total fat (11gm) Saturated fat (1gm) Trans fat (0gm) Cholesterol (< 5mg) Sodium (240mg) Potassium (500mg) Protein (13gm) Carbohydrate (50gm) Sugar (18gm) 17% 5% < 2% 10% 14% 26% 17%

dosage schedule for adults with impaired renal function:

If the serum creatinine concentration of a 31-yearold female patient is 3.9 mg/dl, what would be the recommended daily dose of Primaxin IV in milligrams? (Weight = 85 lbs.) a. b. c. d. 250 500 750 1000

How many total fat calories will be provided by Ensure Plus if the patient is drinking 1000ml per day? a. b. c. d. 101 143 243 413

is 0.25mg/kg/hr, how many ml per minute will be administered to a patient weighing 110 lbs? (Primacor 250ml infusion bag 0.2 mg/ml) a. b. 1.21 2.65

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Krisman a. b. c. d. 39 56 31 13

provides the following information: Amount/serving Total fat (11gm) Saturated fat (1gm) Trans fat (0gm) Cholesterol (< 5mg) Sodium (240mg) Potassium (500mg) Protein (13gm) Carbohydrate (50gm) Sugar (18gm) %DV Serving Size 17% 5% < 2% 10% 14% 26% 17% (8 fl oz) (350 calories)

provides the following information: Amount/serving Total fat (11gm) Saturated fat (1gm) Trans fat (0gm) Cholesterol (< 5mg) Sodium (240mg) Potassium (500mg) Protein (13gm) Carbohydrate (50gm) Sugar (18gm) %DV Serving Size 17% 5% < 2% 10% 14% 26% 17% (8 fl oz) (350 calories)

A normal adult requires 2100 calories per day from their diet. If they are getting all these calories from Ensure Plus, how many protein calories will they get per day? a. b. c. d. 110 234 312 52

W.H.O. recommends 0.45 grams of protein per kilogram of ideal body weight per day. How many bottles of Ensure Plus are required daily for a person weighing 110 lbs? a. b. c. d. 2 5 7 9

provides the following information: Amount/serving Total fat (11gm) Saturated fat (1gm) Trans fat (0gm) Cholesterol (< 5mg) Sodium (240mg) Potassium (500mg) Protein (13gm) Carbohydrate (50gm) Sugar (18gm) %DV Serving Size 17% 5% < 2% 10% 14% 26% 17% (8 fl oz) (350 calories)

provides the following information: Amount/serving Total fat (11gm) Saturated fat (1gm) Trans fat (0gm) Cholesterol (< 5mg) Sodium (240mg) Potassium (500mg) Protein (13gm) Carbohydrate (50gm) Sugar (18gm) %DV Serving Size 17% 5% < 2% 10% 14% 26% 17% (8 fl oz) (350 calories)

How many mEqs of potassium will be present in 720cc of Ensure Plus? (K = 39, Cl = 35)

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Krisman

ANSWERS

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44

Krisman To prepare 65 (30%) 20 parts (75%) needed To prepare 500 (30%) ? = 500 x 20 = 153.84 cc (75%) alcohol 65

The amount of sulfur required to fill the above prescription is 80 x 3 = 2.4 grams. 100

500 x 5 = 25 grams of dextrose. 100

If we mixed 153.84 cc of 75% alcohol with 346.16 cc [500 cc - 153.84 cc] of 10% alcohol, then we can get 500 cc of 30% alcohol solution.

in 1000 cc of solution. The amount of lidocaine in 30 cc of 1:1000 solution can be calculated as follows: = 30 x 1 = 0.03 gm = 30 milligrams. 1000

0.45% heparin solution, therefore we can say = 960 x 0.45 100 = 4.32 gm.

4. (d) 1 grain is equal to 65 milligrams, therefore 1/150 grains are equal to: = 1 x 65 = 0.43 milligrams 150

dosage calculation and can be calculated as follows: We have a suspension ofAugmentin 250 mg/5 cc and we want to dispense dose of 875 mg, = 5 x 875 = 17.5 cc 250 The patient is taking 875 mg twice a day and therefore: = 2 x 17.5 cc = 35 cc per day. Patient is taking drug for 10 days therefore, = 35 x 10 = 350 cc would be the dispensed quantity of drug.

drug in 100 cc of solution. We want to find out how much atropine is required to dispense 1 quart (960 cc) of 1 in 100 solution, therefore: = 960 x 1 = 9.6 gm atropine = 9600 mg. 100

to use the alligation method.

are diluted with water up to 250 cc mark and we want to find out the % of drug in the final solution. = 100 x 0.25 = 0.1% 250

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Krisman

10. (c)

1 teaspoonful (5 cc) of Thioridazine solution (30mg/cc) contains 150 mg of drug. This solution is diluted up to a mark of 480 cc therefore: = 150 = 0.31 mg/ml 480

15. (c)

1 ampul

Patient is taking 100 mcg of the drug I.M. every week, therefore: = 100 = 0.1 cc of drug every week. 1000 The number of cc required for a 1 month supply: = 0.1 x 4 = 0.4 cc

11. (d)

=

We have 12.5mg/5cc Benadryl solution. We want to dispense a 50 mg dose: 50 x 5 = 20 cc for 1 day 12.5 For 30 day supply: = 20 x 30 = 600 cc.

Erythromycin 2% topical solution contains = 60 x 2 100 = 1.2 gm of erythromycin.

1000 tablets of Risperdal 1mg cost $2250. The % mark up on prescriptions is 20%. Therefore the retail price of 1000 tablets would be: = 120 x 2250 = $2700 100 ** Each $100 cost = $120 retail cost** Price for 30 tablets would be: = 30 x 2700 = $81 1000

13. (c)

14. (b)

60 gm, 1%: 60 100

17. (d)

= 0.6 gm of hydrocortisone.

We want to find out the quantity of Clobetasole present in 60 grams of 0.5% ointment. = 60 x 0.5 = 0.3 gm of clobetasole. 100

18. (c)

% of hydrocortisone in final mixture = 100 x 2.6 (2 gm + 0.6 gm) 140 (80 gm + 60 gm) = 1.85% w/w. pH

A pH of the solution can be found by the following formula: = pKa + log ionize unionize

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Reference Guide For Pharmaceutical Calculations Third Edition = 2.2 + log 103 = 2.2 + 3 = 5.2

Krisman

24. (d)

pH = - log [H3O+]

19. (b)

We have 400 mg/5 cc Augmentin in stock. We want to find the dispensed quantity for a 10-day supply. = 875 x 5 = 10.93 cc for each dose 400 The patient is taking a dose twice a day for 10 days therefore : = 10.93 x 2 x 10 = 218.75cc

25. (d)

26. (d)

tion contains:

= 500 cc x 1.25 gm/cc = 625 gm

= 240 x 2 = 4.8 gm of Erythromycin 100 The number of 500 mg tablets of Erythromycin: = 4800 = 9.6 10 tablets. 500

21. (a)

27. (c)

22. (b)

28. (a)

Weight = density x volume

100 tablets of 1grain of Aspirin contains: 100 x 65 = 6500 mg of Aspirin. The number of 975 mg tablets ofAspirin: = 6500 = 6.66 6 tablets 975

23. (c)

pH = pKa + log salt acid 7 = 5 + log salt acid log [salt/acid] = 2 salt/acid = 10 , ratio of ionized to unionize drug will be 100.

2

29. (b)

contains:

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Reference Guide For Pharmaceutical Calculations Third Edition The addition of 3 capsules each weighing 150 mg will result in: 1.5 gm + 0.45 gm = 1.95 gm % of Clindamycin in final mixture would be: = 1.95 x 100 = 1.3% 150

Krisman = Body surface area of child x adult dose 173 mm2 = 20 x 100 173 = 11.56 mg

30. (a)

71.42 mg

34. (d)

35. (c)

Patient weight is 156 lbs, therefore weight in Kg would be 156 = 70.9 kg. 2.2 A normal therapeutically recommended dose of drug is 10mg/kg/day, therefore the dose in the above patient is: = 10 x 70.9 = 709 mg Each ready-infusion-bag contains 250 mg of drug, so the number of bags required to fill the order would be = 709 = 2.83 3 bags. 250

31. (a)

100 mg

Clarks rule = Weight in lbs x adult dose 150 = 20 x 750 = 100 mg 150

32. (c)

0.06 cc

According to Frieds rule: = age in months x adult dose 150 = 15 x 325 = 32.5 mg 150 The dropper is calibrated to deliver 325 mg of Iron sulfate in 0.6 cc, therefore: = 0.6 x 32.5 = 0.06cc 325

36. (b)

[1 mg = 1000 mcg]

33. (d)

11.56 mg

A prescription calls for 50 mcg of a drug three times a day for 10 days, therefore the number of tablets required to fill the order is: = 50 x 3 x 10 = 2.30 3 tablets 650

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Krisman

37. (a)

A patient is taking 125 mcg of Lanoxin every day, therefore to fill a 30 day order, = 30 x 125 = 3750 mcg of Lanoxin. Each ml of Lanoxin elixir provides 50 mcg of a drug, therefore the number of cc required to fill the entire order is: = 3750 = 75 cc of Lanoxin elixir. 50

41. (d)

477 mg

An adult dose of drug can be calculated by the following formula: Body surface area x adult dose 173 mm2 = 110 x 750 = 476.87 mg 477 mg 173

A prescription reads to dissolve 2 gm of Guaifenesin in 100 cc of plain water, therefore the amount of drug present in 1 teaspoonful (5 cc) of solution would be = 5 x 2000 = 100 mg = 100 = 1.53 grain 100 65 contain:

43. (c)

39. (b)

100 mg of Lactaid is equal to 4500 units, therefore 1 unit is equal to: = 100 = 0.02 mg of Lactaid 4500 = 750 x 0.9 = 6.75 gm of sodium chloride 100

44. (b)

D25W will be interpreted as 25% Dextrose solution. The amount of dextrose present:

40. (c)

A 7 year-old child is taking 50 mgAmpicillin by mouth twice a day for 7 days, therefore: = 50 x 2 x 7 = 700 mg ofAmpicillin We have 125 mg/5 cc suspension in stock: = 5 x 700 = 28 cc 125

45. (a)

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49

46. (a)

1.33 gm of Povidone-Iodine.

52. (b)

= 1000 = 1.33 gm of povidone iodine 750

1 in 500 solution is interpreted as 1 gm of drug in 500 cc solution, therefore: = 3 x 960 x 1 = 5.76 gm of Atropine. 500

47. (b)

20 gm of dextrose

53. (a)

50 grams.

48. (c)

54. (a)

49. (d)

quired:

= 250 x 5 = 12.5 gm of drug = 12,500 mg 100 Stock solution of thioridazine required: = 12,500 = 416.66 cc 417 cc 30 To prepare 4 parts (3%) To prepare 500 gm 2 parts (5%) ?

50. (d)

20 cc of 1 mg/cc Risperdal solution contains 20 mg of drug. Strength of Risperdal in the final solution: = 20 = 0.08 mg /cc 240

55. (b)

To solve this problem, we must first find out the amount of drug present in the final solution. The amount of atropine in 1 pint, 1 in 500 soln = 480 x 1 = 0.96 gm of atropine. 500 Now, 0.96 gm of drug must be present in 1 teaspoonful of the drug solution, therefore we can say:

51. (c)

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50

Reference Guide For Pharmaceutical Calculations Third Edition This 150 mg will be present in 240 cc of solution therefore: = 150 mg/240 cc = 0.625 mg/cc 10 cc (6.25 mg) of this resultant solution is diluted up to 1000 cc: = 6.25 mg/1000 cc = 0.00625 mg/cc = 6.25 mcg/cc

Krisman We have to infuse 100 cc/250 mg Rocephine via I.V. infusion over a 12 hour period: = = 100 cc/12 x 60 minutes 0.138 cc/min

I.V. set delivers 20 drops/cc: = = = 20 drops/cc 2.77 drops/0.138 cc 2.77 drops/min 22.91 drops/min

243. (b)

307.69 mOsm

246. (d)

mOsml/L = wt (g)/L x no. of species x 1000 mw (g) Amount of NaCl: = = = = 200 x 0.009 gm 1.8 gm/200 cc 9 gm/1000 cc 9 x 2 x 1000 58.5 = 307.69 mOsm/L 2684.56 mOsm/L

We need to infuse 20 cc + 50 cc + 30 cc + 1000 cc = 1100 cc within 8 hours, therefore, = 1100 cc/8 x 60 = 2.291 cc/min I.V. set delivers 10 drops/cc, = 10 drops/cc = 22.91 drops/2.291 cc = 22.91 drops/min

244. (c)

247. (d)

Amount of KCl: = 30 x 0.1 = 3 gm KCl/30 cc = 10 gm/100 cc = 100 gm/1000 cc mOsm/L of KCl:

8.33 hours

We want to infuse 500 cc D5w solution with a flow rate of 20 drops/min. The I.V. set delivers 20 drops/cc, therefore one can say: = 20 drops/min = 20 drops/cc

or

1 cc / min

Time required to complete the infusion: = 100 x 2 x 1000 74.5 = 2684.56 mOsm/L = 500 cc/1 = 500 minutes = 8.33 hours

248. (b)

18.75 drops/min

245. (d)

2.77 drops/min

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Reference Guide For Pharmaceutical Calculations Third Edition I.V. set delivers 15 drops/cc therefore: = 1.25 cc/min = 18.75 drops/min CrCl =

CrCl (female) =0.85 x male (CrCl) = 185/2.2 x (140 - 52) / 72 x 3.7 = 27.78 ml/minute

249. (b)

3 bags

Patient wt in kg = 155/2.2 = 70.45 kg A normal therapeutic dose in mg is 10 mg/kg/ day: = 10 x 70.45 mg = 704.5 mg The number of I.V. infusion bags: = 704.5/250 = 2.82 3 bags

drug for a patient weighing 110 lbs. should be: = 110 x 4 x 0.01 / 2.2 = 2 mcg The number of (2 mcg/ml) ampules required: = 2/2 = 1 ampule

250. (a)

1 in 100 is interpreted as 1 gm of dextrose solution in 100 cc: Amount of dextrose: = = 50/100 0.5 gm

254. (a) The total dose a patient should be getting per minute: = 0.25mcg x 110 / 2.2 = 12.5mcg/min Time required to finish up a 2.5mg (2500mcg) dose: = 2500 / 12.5 = 200 minutes = 200 / 60 = 3.33 hours = 4 hours

= 480 x 5 / 100 (1 pint = 480 ml) = 24gms = 24000mgs The number of mEqs of sodium ions:

= 24000mgs / 84 (1mEqs NaHCO3 = 84mg)(equivalent weight = mw / no of valence) = 285.71mEqs of sodium bicarbonates = 285.71mEqs of Na = 285.71mEqs of HCO3in 12 oz of water: = 40mEq / 360cc = 0.11mEq / cc 5cc of this resultant (0.11mEq/ml) solution is diluted up to the 25cc mark, therefore: = 5 cc x 0.11mEq = 0.55mEq / 5cc

available, the following formula (based on sex, weight and age of the patient) may be used to convert this value into creatinine clearance. www.pharmacyexam.com

79

Reference Guide For Pharmaceutical Calculations Third Edition = 0.55mEq / 25cc = 0.02mEq / cc = 0.02 x 74.5mg (1 mEq = 74.5mg) = 1.64 mg / cc = 640mcg

Krisman

Lopinavir and 20mg Ritonavir per ml, therefore: = 400 / 20 = 20cc A 7-day supply would be: = 20 x 7 = 140cc

by using the following formula: CrCl = weight (kg) x (140-age) 72 x serum creatinine (mg/dL)

required to provide 100 calories (0.1Kcal): = 100 / 240 (since 1cc = 1 calorie) = 0.42 = 1 bottle

= 85 x (140-31) / 2.2 x 72 x 3.9 = 15ml/minute CrCl (female) =0.85 x male (CrCl) = 0.85 x 15 = 12.75ml/minute Therefore, the recommended dose should be 500mg every 12 hours. The daily dose should be 1000mg.

a 0.015% eye drop: = 0.015 / 100 = 0.00015gm = 0.15mg

0.25mg/kg/hr, therefore: = 0.25 x 110 / 2.2 = 12.5mg Primacor will be required per hour, so: = 12.5mg/0.2 (1ml = 0.2mg Primacor) =62.5ml Therefore, 62.5ml Primacor solution should be administered to a patient within 1 hour in order to a provide 12.5mg dose. Therefore: = 62.5ml/1 hr = 62.5ml/60 minutes = 1.04ml/minute

each ml of solution: = 0.0002 / 100 = 0.000002gm = 0.000002 x 1000mg = 0.002mg

= 32 x 2 = 64mcg (32mcg for each nostril) The total number of micrograms present in a nasal spray bottle: = 40 x 16

in elixir dosage form:

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Reference Guide For Pharmaceutical Calculations Third Edition = 5 x 25mcg = 125mcg = 0.125mg (1mg = 1000mcg) Since elixir provides 80% bioavailability (means 20% less bioavailability than I.V. dosage form), one can say: = 0.125 x 20 / 100 = 0.025mg This means an I.V. dosage of Lanoxin requires 0.025mg less compared to elixir dosage form, therefore: = 0.125 - 0.025 = 0.100mg dose is required when using an I.V. dosage formulation.

Krisman Total number of mEqs present in 720cc: = 12.82 x 3 = 38.4 mEqs = 39 mEqs

person weighing 110 lbs: = 110 x 0.45 / 2.2 = 22.50gm Each Ensure Plus bottle provides 13gm of protein, therefore: = 22.5 / 13 = 1.73 =2

therefore: = 11gm x 9 x 1000 / 240 (8 oz = 240cc) = 412.5 calories = 413 calories

4 oz (120cc) Ensure Plus: = weight in mg / equivalent weight = 250 / 39 (1 equivalent = 39mg K) = 6.41mEqs The number of mEqs of potassium in 10gm KCl powder: = weight in mg / equivalent weight = 10000 / 74 (1 equivalent = 74mg KCl) = 135.14mEqs KCl = 135.14 mEqs K+ = 135.14 mEqs Cl- (since KCl = K+ + Cl-) Total mEqs:

required per day: = 2100 / 350 = 6 bottles Each bottle contains 13gm protein, therefore: = 13gm x 6 = 78gm protein = 78 x 4 (1gm protein = 4 calories) = 312 calories

present in 8 oz (240cc) of Ensure Plus: = weight in mg / equivalent weight = 500mg / 39 (1 equivalent weight = 39mg) = 12.82mEqs potassium www.pharmacyexam.com

Dextrose 5% solution: = 1000mg / 505ml (5ml SWFI + 500ml D5W solution) = 1.98mg / ml 81

Krisman

required daily is: = 15 x 6 = 90mg Therefore, the Duragesic dose should be 25mcg/ hr. This patch should be replaced every 3 days. To fill the 30-day supply, we need 10 patches (25mcg/hr).

children can be calculated by using the following formula: Schwartz equation: CrCl (ml/min)= [length (cm) x k] / Serum creatinine Patient population: 1. Infants 1 to 52 weeks old k = 0.45 2. Children 1 to 13 years old k = 0.55 3. Adolescent females 13-18 years old k = 0.55 4. Adolescent males 13-18 years old k = 0.70 Therefore, for the above patient, the CrCl is: = k x length (cm) / serum creatinine = 0.55 x 24 x 2.54 / 2.1 (1 inch = 2.54 cm) = 15.96ml/min = 16ml/min

CrCl = weight (kg) x (140-age) 72 x serum creatinine (mg/dL)

= 57 x 2.2 = 125.4 lbs. = 125lbs. The recommended dose of Vermox suspension in ml: = 1250 x 5 / 250 (from chart 125 lb = 1.25gm) = 25mls

factor for converting the daily dose of prior opioids to the daily dose of oral oxycodone: Daily dose of oxycodone (mg) = multiplication factor x prior opioid (mg/day) = 0.5 x 60mg = 30mg Therefore, 60mg of oral morphine is equivalent to 30mg of oral oxycodone. The number of 5mg oxycodone tablets required to fill a 7-day supply: = 30 x 7 / 5 = 42 tablets

milligrams: = 20 x 155 x 21 / 2.2 = 29,590mg Each Septra DS contains 160mg trimethoprim and 800mg sulfamethoxazole. Therefore, the number of tablets required is: = 29590 / 160 = 184.93 = 185 www.pharmacyexam.com

factor for converting the daily dose of prior opioids to the daily dose of oral hydromorphone: 82

Reference Guide For Pharmaceutical Calculations Third Edition PRACTICE TEST 1. How many milligrams are present in a 1/150 gr Nitrostat tablet? a. b. c. d. 1.2 mg 0.43 mg 45 mg 3.5 mg a. b. c. d. 0.5 gm 0.005 gm 10 gm 1 gm

Krisman

7. How many grams of Lidocaine are required to dispense 1 quart of 1 in 50 solution? a. b. c. d. 11.4 gm 5 gm 19.2 gm 21 gm

2. How many 1/200 gr of tablets can be prepared from 500 mg of active ingredient? a. b. c. d. 167 432 1538 1100

8. How many calories are provided by 1 quart of a 1 in 500 solution of dextrose? a. b. c. d. 11.2 calories 9.55 calories 55.6 calories 6.53 calories

3. How many milligrams of Guiafenesin will be present in 480cc (15 mg/5 cc) of solution? a. b. c. d. 908 mg 1440 mg 1000 mg 521 mg

4. If the retail cost of each Zyprexa tablet is $2.40, what would be the retail cost for 30 tablets? a. b. c. d. 72 111 24 67

10. In what proportion should 49% alcohol be mixed with water to prepare 1000 cc of a 25% alcohol solution? a. b. c. d. 30.5 cc 810 cc 111 cc 510.2 cc

5. How many grams of dextrose are required to prepare a 1000 cc D5w solution? a. b. c. d. 125 gm 75 gm 50 gm 500 gm

11. How much Heparin is required to dispense a 0.25% 750 cc solution? a. b. c. d. 1.875 gm 5.25 gm 0.115 gm 2.10 gm

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88

Reference Guide For Pharmaceutical Calculations Third Edition 12. If a prescription calls for Biaxin 500 mg po bid x 10 days, how many cc of Biaxin 125 mg/5 cc are required to dispense a 10 day supply? a. b. c. d. 200 cc 100 cc 400 cc 50 cc c. d. 2.083 mcg/ml 5.10 mcg/ml

Krisman

17. How many cc of 10% Benzoyl peroxide are required to prepare a 5% 20 cc Benzoyl peroxide solution? a. b. c. d. 10 cc 50 cc 25 cc 100 cc

13. If a prescription is written to take 50 mg of diphenhydramine by mouth four times a day for 5 days, how many cc of 12.5 mg/5 cc diphenhydramine solution are required to dispense 5 day supply? a. b. c. d. 400 cc 20 cc 80 cc 10 cc

18. How many milligrams of Clindamycin are present in 60 cc of 0.1% topical gel of clindamycin? a. b. c. d. 100 mg 30 mg 60 mg 45 mg

14. If 125 mcg of a drug are diluted with water up to 50 cc, what is the % of drug ? a. b. c. d. 0.25% 1.25% 0.00025% 0.0025%

19. How many tablets of 250 mg erythromycin are required to prepare 500 cc of 2% topical solution of erythromycin? a. b. c. d. 10 40 80 20

15. If 1 tablespoonful of Thioridazine intense solution (100 mg/cc) is diluted with water up to 1 quart, what is the % of drug in the final solution? a. b. c. d. 1.25% 0.005% 0.156% 2.75%

20. If 325 mg of ferrous sulfate contains 22% elementary iron, how many milligrams of elementral iron will the patient receive with each dose? a. b. c. d. 20 mg 60 mg 71.5 mg 50 mg

16. If 10 teaspoonfuls of Risperdal oral solution (100 mcg/5 cc) are diluted with water up to 480 cc, what is the concentration of drug in mcg/ cc in the final solution? a. b. 1.2 mcg/ml 2.5 mg/ml

21. If niferex liquid solution provides 10 mg of elementral iron in 1 teaspoonful, how many cc of solution are required to provide 55 mg of elementral iron ?

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89

Reference Guide For Pharmaceutical Calculations Third Edition 345. 346. 347. 348. 349. 350. 351. 352. 353. 354. 355. 356. 357. 358. 359. 360 361. 362. 363. 364. 365. C D D C D A C A A A B C A A B C A D D B A

Krisman

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